A 30-year-old male presents with recurrent moderate to massive hemoptysis since age 15, occasionally with purulent sputum. Recently, he coughed up 50ml of blood. Physical exam reveals fixed rales in the right lower lung. Chest X-ray shows coarse lung markings bilaterally. Clinical diagnosis is bronchiectasis. The patient requests surgical treatment, and the physician advises further evaluation. The decisive factor for determining surgical candidacy in this patient is: